florida health care plans east volusia area network referral instructions

VARICOSE VEIN TREATMENT
Thomas Corbyons, M.D. #004024
Michael Donohoe, M.D. #003724
Michele Taylor-Caldwell, A.R.N.P. #118556
All ages
Utpal Desai, M.D. #009810
John B. Holt, M.D. #000426
William H. Johnson, M.D. #000018
Bradley Litke, M.D. #001876
James Wuamett, M.D. #001827
Patients 10 years and older
Sukhender Singireddy, M.D. #010488
Charles Stein, M.D. #005416
Corbyons & Donohoe Surgical Assoc.
685 Peachwood Dr., DeLand, FL 32720 386 / 738-5300
Fax: 386 / 738-9537
Coastal Cardiovascular & Thoracic Associates, P.A.
588 Sterthaus Drive, Ormond Beach, FL 32174 386 / 672-9501
Fax: 386 / 673-0308
Suncoast Vein & Treatment
1680 Dunlawton Ave., Port Orange, FL 32127
Vein Treatment Center
21 Hospital Drive, Suite 260, Palm Coast, FL 32164
1414 W. Granada Blvd., Suite 3, Ormond Beach, FL 32174
386 / 304-1212
Fax: 386 / 304-4432
386 / 586-5344
Fax: 386 / 586-5356
REFERRAL INSTRUCTIONS: Complete the FHCP Referral form. Attach pertinent documentation and dictation needed to substantiate this
request. Distribute the form as follows: White, Pink, & Yellow: Send to the Referral Department at FHCP’s Daytona Beach facility, via FHCP
courier. Blue: Give to the member.
The Referral Department will review the request and if approved, will schedule the member’s appointment with this specialist, record the
appointment date and time on the request form and return the completed Yellow copy to your office for your records.
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